ATI LPN
Pediatric ATI Proctored Test
1. Which of the following is an indication of lower respiratory infection?
- A. Cough
- B. Fever
- C. Inability to lie supine
- D. Shortness of breath
Correct answer: C
Rationale: Inability to lie supine is a significant indication of lower respiratory infection. This symptom often occurs due to breathing difficulties and discomfort experienced by individuals with lower respiratory infections, such as pneumonia or bronchitis. It can be caused by lung inflammation, consolidation, or fluid buildup in the lungs, making lying flat uncomfortable or difficult. Monitoring a patient's ability to lie flat can provide valuable information about the severity and progression of a lower respiratory infection.
2. What is a priority discharge instruction for a parent of a child experiencing the first episode of asthma?
- A. Asthma can be prevented by avoiding environmental and emotional triggers
- B. Asthma decreases the size of the airway causing distress
- C. Bronchodilators can cause tachycardia and restlessness
- D. If an attack occurs at home, the child should sit or stand
Correct answer: A
Rationale: Educating parents about avoiding triggers is a crucial part of managing asthma in children to prevent future asthma attacks. By identifying and minimizing exposure to triggers, parents can help reduce the risk of asthma exacerbations and improve the child's overall quality of life.
3. What is the reason for Asthma in 4-year-old Mabele, as Mrs. Joyce Thomson inquires? How would you explain it?
- A. Asthma occurs due to inflammation of the respiratory tract triggered by infections.
- B. An asthmatic attack can occur when the child is exposed to certain allergens, triggering an allergic reaction in the bronchioles that causes bronchial constriction.
- C. An asthmatic attack is a response to the release of inflammatory mediators to epithelial cells, affecting the autonomic neural control of the airway.
- D. Asthma is not an inborn problem; it involves abnormal growth of the bronchial tree causing restriction.
Correct answer: B
Rationale: Asthma in children like Mabele can be triggered by exposure to allergens, leading to an allergic reaction in the bronchioles. This reaction causes constriction of the bronchial tree, resulting in an asthmatic attack. It is essential for caregivers to identify and minimize exposure to these triggers to manage and prevent asthma episodes effectively.
4. Following the initial steps of resuscitation, a newborn remains apneic and cyanotic. What should you do next?
- A. begin ventilations with a bag-mask device.
- B. gently flick the soles of their feet for up to 60 seconds.
- C. immediately suction their mouth and nose.
- D. start CPR if the heart rate is less than 80 beats/min.
Correct answer: A
Rationale: If a newborn remains apneic and cyanotic after the initial resuscitation steps, the next appropriate action is to begin ventilations with a bag-mask device. This helps provide oxygen to the newborn and can be crucial in supporting their respiratory efforts. Option B of flicking the soles of their feet is not recommended in this scenario as the priority is addressing the respiratory distress. Option C of suctioning their mouth and nose is not the immediate next step if the newborn is not spontaneously breathing. Option D of starting CPR based only on the heart rate is not the first-line intervention for an apneic and cyanotic newborn.
5. In the pediatric ward at Nyamebekyere teaching hospital, when should oxygen be applied to children?
- A. Central cyanosis
- B. Respiratory rate >70 breaths per minute
- C. Grunting noted on assessment
- D. All of the above
Correct answer: D
Rationale: All the listed conditions, central cyanosis, respiratory rate >70 breaths per minute, and grunting on assessment, are indicative of the need for oxygen therapy. Central cyanosis suggests severe hypoxemia, a respiratory rate >70 breaths per minute can indicate respiratory distress, and grunting is a sign of increased work of breathing. Administering oxygen in these situations can help improve oxygenation and support the child's respiratory function, making option D the correct choice.
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